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Published on: August 7, 2017
Antibiotic use in children is associated with increased risk of asthma
Fawziah Marra1, Carlo A Marra, Kathryn Richardson
1University of British Columbia, Faculty of Pharmaceutical Sciences, Centre for Health Evaluation and Outcomes Sciences, St Paul's Hospital, 620-1081 Burrard St, Vancouver, British Columbia, Canada. carlo.marra@ubc.ca
Insights
Early childhood antibiotic use is linked to a small increased risk of childhood asthma. This risk grows with more antibiotic prescriptions, particularly over four courses.
Area of Science:
- Pediatric Medicine
- Epidemiology
- Pharmacology
Background:
- Rising asthma prevalence in industrialized nations is a public health concern.
- Early childhood antibiotic exposure is a suspected contributing factor, but previous research is conflicting.
Purpose of the Study:
- To investigate the association between antibiotic exposure in the first year of life and the subsequent development of childhood asthma.
Main Methods:
- A large birth cohort (N=251,817) from 1997-2003 was analyzed using administrative data.
- Antibiotic exposure was tracked during the first 12 months of life.
- Cox proportional hazards models adjusted for numerous potential confounders to assess asthma incidence.
Main Results:
- Antibiotic exposure in the first year of life showed a small association with increased asthma risk.
- Risk increased with the number of antibiotic courses, with >4 courses showing the highest risk.
- Sulfonamides were the only antibiotic class not associated with increased asthma risk.
Conclusions:
- Antibiotic use in infancy is associated with a small but significant risk of developing childhood asthma.
- The risk escalates with the number of antibiotic courses prescribed during the first year of life.
Background:
Antibiotic exposure in early childhood is a possible contributor to the increasing asthma prevalence in industrialized countries. Although a number of published studies have tested this hypothesis, the results have been conflicting.
Objective:
To explore the association between antibiotic exposure before 1 year of age and development of childhood asthma.
Methods:
Using administrative data, birth cohorts from 1997 to 2003 were evaluated (N = 251817). Antibiotic exposure was determined for the first year of life. After the first 24 months of life, the incidence of asthma was determined in both those exposed and not exposed to antibiotics in the first 12 months of life. Cox proportional hazards models were used to adjust for potential confounders and determine the hazard ratios associated with antibiotic exposure for the development of asthma.
Results:
Antibiotic exposure in the first year of life was associated with a small risk of developing asthma in early childhood after adjusting for gender, socioeconomic status at birth, urban or rural address at birth, birth weight, gestational age, delivery method, frequency of physician visits, hospital visit involving surgery, visits to an allergist, respirologist, or immunologist, congenital anomalies, and presence of otitis media, acute, or chronic bronchitis, and upper and lower respiratory tract infections during the first year of life. As the number of courses of antibiotics increased, this was associated with increased asthma risk, with the highest risk being in children who received >4 courses. All antibiotics were associated with an increased risk of developing asthma, with the exception of sulfonamides.
Conclusions:
This study provides evidence that the use of antibiotics in the first year of life is associated with a small risk of developing asthma, and this risk increases with the number of courses of antibiotics prescribed.
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